Comparison of flap outcomes between single- and multiple-perforator-based free anterolateral thigh flap in head and neck reconstruction

Kuan Chih Wang, Chia Chin Tsai, Chih Hao Chang, Wan Ling Tseng, Kuo Shu Hung, Tzu Yen Chang, Szu Han Chen, Yao Chou Lee

研究成果: Article同行評審

2 引文 斯高帕斯(Scopus)

摘要

Introduction: The number of perforators required for safe perfusion remains under debate. This study aimed to determine whether a single- or multiple-perforator-based anterolateral thigh flap yields better flap outcomes in head and neck reconstruction. Patients and Methods: Between August 2012 and July 2016, 180 men and 4 women with a mean age of 52.8 ± 9.8 years underwent head and neck anterolateral thigh flap reconstruction for oncologic defect in 181 cases, plate exposure in two cases, and trismus release in one case. The flap was patched for inner or external lining, folded for through–through defect, or tubed for cervical esophageal reconstruction. Of 184 flaps, 136 (73.9%) were based on multiple perforators (range, 2–5 perforators), whereas 48 (26.1%) were based on a single perforator. The demographics, operative findings, and flap outcomes were compared. Results: The prevalence of systemic diseases between groups was comparable. The mean flap size in the single-perforator group was smaller (92.8 ± 36.8 vs. 140.5 ± 99.9 cm 2 , P <.0001). Twenty-one flaps (11.4%) required emergency take-back and 13 (61.9%) were successfully salvaged. Eight flaps failed, yielding a 95.7% flap survival rate. The single-perforator group had a significantly higher rate of emergency take-back for vascular compromise (8/48 (16.7%) vs. 8/136 (5.9%), P =.035), a decreased salvage success rate (2/8 (25.0%) vs. 11/13 (84.6%), P =.018), and a corresponding lower flap survival rate (42/48 (87.5%) vs. 134/136 (98.5%), P =.004). Conclusion: Whenever possible, we recommend including multiple cutaneous perforators in anterolateral thigh flaps to yield better flap outcomes in head and neck reconstruction.

原文English
頁(從 - 到)150-155
頁數6
期刊Microsurgery
39
發行號2
DOIs
出版狀態Published - 2019 二月 1

All Science Journal Classification (ASJC) codes

  • Surgery

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